Is Cadaver Cartilage for Revision Better Than Ear Cartilage?

There appear to be trends and conflicting information on the use of irradatiated rib cartilage. Clearly the advantages are that no donor site or additional srugery is necessary. However, any rib  cartilage yours or a cadaver can warp. Interventions such as metal wires placed into the graft may help minimize this tendency but may require removal at a later date. Ear cartilage will not be rejected but the ability to shape of provide sufficient bulk or structure may be more limited.

There are Pros and Cons for using Irradiated vs Autologous Rib Cartilage in Revision Rhinoplasty Patients-

1. Irradiated Rib Cartilage- No donor site morbidity, ease of use , less warping but more resorption than Autologous Rib Cartilage

2. Autologous Rib Cartilage- Abundant, donor site morbidity, ease of carving, more warping tendency but less resorption .

In my personal experience, I have moved to using only autologous material- septum , ear or rib in the management of revision rhinoplasty patients for enhanced long term results, safety ,and less resorption rates .

Good question.  There is still some controversy regarding the use of irradiated cadaveric rib cartilage in nasal reconstruction.  The main concern was not safety, but resorption of the homologous rib graft over time.  Recent studies have shown that about one third of these grafts will lose support and resorb over time.  This would be a problem in cases like yours, were the surgeon is trying to lengthen the nose or reconstruct the septum. In bigger reconstructive cases,  a patient's own rib cartilage would be my first choice. However, if (for whatever reason) rib harvest is not available, then irradiated homologous rib grafts would be my next best option in these cases.